2022 Fiscal Year Final Research Report
Exploration of predictive markers and establishment of preventative and therapeutic measures for chronic postsurgical pain targeting central sensitization mechanisms
| Project/Area Number |
20K09206
|
|---|
| Research Category |
Grant-in-Aid for Scientific Research (C)
|
| Allocation Type | Multi-year Fund |
|---|
| Section | 一般 |
|---|
| Review Section |
Basic Section 55050:Anesthesiology-related
|
|---|
| Research Institution | Keio University |
|---|
Principal Investigator |
|
|---|
| Co-Investigator(Kenkyū-buntansha) |
小杉 志都子 慶應義塾大学, 医学部(信濃町), 准教授 (00317249)
加藤 純悟 慶應義塾大学, 医学部(信濃町), 講師 (40465018)
寅丸 智子 慶應義塾大学, 医学部(信濃町), 助教 (70594612)
|
|---|
| Project Period (FY) |
2020-04-01 – 2023-03-31
|
| Keywords | 術後痛遷延化 / 慢性痛 / 中枢性炎症 / fractalkine / ミクログリア |
|---|
| Outline of Final Research Achievements |
In the clinical study targeting chronic knee pain patients, we have demonstrated that preoperative multi-dimensional pain evaluation has relevant predictive values for predicting chronic postsurgical pain (CPSP) six months after knee surgery. Moreover, the analyses of cerebrospinal fluids (CSF) collected preoperatively revealed that the preoperative level of fractalkine in the CSF negatively correlated with the severity of CPSP. In the basic research part, we discovered that the spatially selective activation of microglia in the dorsal horn of spinal cord aggravated postoperative pain in a mouse model of postsurgical pain. These findings implicate that pharmacological manipulations that lead microglia toward anti-inflammatory M2 type would suppress the transition to CPSP. Taken together these findings from both clinical and basic studies, we will explore the potential protective effects of central fractalkine on neuroinflammation in the context of CPSP.
|
| Free Research Field |
麻酔学
|
| Academic Significance and Societal Importance of the Research Achievements |
本研究によりPain Catastrophizing Scaleをはじめとする多面的な心理社会面を含めた術前評価の、術後痛遷延化の予測における臨床的価値を示すことができた。こうした多面的評価を術前評価に組み込むことで術後痛遷延化のリスクを評価し、予防法を講じることで、術後痛の軽減・社会復帰への促進につながることが期待される。髄液解析で示されたfractalkine濃度と術後痛遷延化の負の相関は、術後痛遷延化におけるfractalkineの保護的作用を示唆するものであり、術後痛遷延化予防の新規治療法への発展につながる知見である。
|
